Voice of America - August 30, 2005
Joe De Capua
Washington

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The Bush Administration has rejected allegations it's pressuring the Ugandan government to promote abstinence over condom use in preventing HIV/AIDS. It also denies its policies have contributed to a reported condom shortage in Uganda.

Dr. Mark Dybul, Deputy US Global AIDS Coordinator, denies the United States is exerting any pressure on Uganda to change its AIDS prevention approach. He says, "Nothing could be more absurd."

Dr. Dybul says the Bush Administration supports Uganda's ABC prevention system.

"Fifteen years ago, long before it became fashionable for international organizations to pop into Uganda for a couple of days and tell them how to run their country, the Ugandans developed what's known as ABC - abstain, be faithful and, if you can't do either, correct and consistent use of condoms. This approach has been remarkably successful by all documentation," he says.

He says it's true the Bush Administration is now stressing A & B - abstinence and being faithful - because an overemphasis has been placed on C, condom use, in some areas. Dr. Dybul says that's to ensure there's a balanced ABC approach in the country.

"In concentrated epidemics, where the infection is concentrated among prostitutes, drug users, truckers, condom-only approaches tend to work fairly well because you have a concentrated group of people. In a generalized epidemic, which is what we see in Uganda, throughout all of Africa, where the infection is already in the general community, only an ABC approach works. Condoms-only is a failed, failed approach," he says.

In a news conference, UN special envoy Stephen Lewis, and AIDS activists, took aim at PEPFAR, the President's Emergency Plan for AIDS Relief.

"There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated by PEPFAR and by the extreme policies that the administration in the United States is now pursuing in the emphasis on abstinence far and away beyond that of condoms, " he says.

Mr. Lewis calls it a "distortion of the preventive apparatus of ABC." He adds, "It's causing "great damage" and says it will lead to more HIV infections.

The Deputy US Global AIDS Coordinator, Dr. Dybul, denies US policy contributed to a condom shortfall in Uganda. He says it was clearly a case of a questionable product being on the market.

"The difficulty in Uganda is because a large batch of condoms that was ordered in Uganda smelled bad and people complained about them. They were tested and found to have a lot of holes in them. So they had to pull them from the market, which is good public health strategy. You have a bad commodity on the market, you pull it from the market, same thing we do in the United States or anywhere else in the world. It is preposterous to say that a policy of ABC led to the production of bad condoms," he says.

Later tests showed the condoms to be safe but public confidence in the brand, Engabu, was extremely low after the bad publicity. AIDS activists accuse the Ugandan government of not acting quickly enough to obtain more condoms. They say government clinics no longer offer free condoms, and those that can be purchased have tripled in price.

The Bush Administration says it has sent large amounts of condoms to Uganda to deal with the problem, and that they are awaiting the country's quality control testing.The Administration also denies most of the PEPFAR money goes to faith-based organizations. However, it highly praises such organizations, saying they should receive more aid and that the pandemic cannot be defeated without their help.

Note: Above audio links include full interview with Dr. Dybul, beginning with his denial the US is pressuring Ugandan government.

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